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Prenatal Education & Infertility Flashcards

1
Q

What is the overall goal of prenatal education ?

A

empowerment so that the patient can make a informed decision about their pregnancy

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2
Q

How do we empower the woman in her pregnancy ?

A
  • give options for safe delivery of care
  • recognize that the patient has a right to evidence-based, accurate and complete information
  • recognize that the patient’s choice may align with their cultural and personal values and preferences
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3
Q

What does Early Pregnancy education look like ?

A

knowing the expected changes your body goes through
- fetal development
- physiological/emotional changes
- sexuality
- nutrition

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4
Q

What does Mid Pregnancy education look like ?

A

prepping the patients for parenting
- breastfeeding
- infant health and care
- safe sleep methods
- parenting
- changing diapers

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5
Q

What does Late Pregnancy education look like ?

A

preparing for delivery and the birthing process
- coping with labor and birth
- touring the location where you may be giving birth

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6
Q

What is considered a low-risk pregnancy ?

A

pregnancy with no previous or current maternal or fetal implications

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7
Q

What is a doula ?

A

a person who offers support during labor and postpartum
- can be certified
- usage has shown to reduce use of analgesics, shorten labor, increase satisfaction with delivery, increase breastfeeding, increase likelihood of spontaneous vaginal delivery

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8
Q

What is a Certified Nurse Midwife ?

A

has a Nursing background and a advanced degree
- Masters in midwifery

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9
Q

What is a Direct-Entry Midwife ?

A

is credentialed but got this without a Nursing background
- has formal education and is certified

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10
Q

What is a Traditional/Lay Midwife ?

A

not certified by instead trained by self-study or apprenticeship

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11
Q

What is a birth plan ?

A

a tool in which parents can explore childbirth options and develop a “plan” for the day
- helps communicate preferences to healthcare team
- can give pt’s a sense of control and responsibility

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12
Q

What are some considerations with a birth plan ?

A
  • should be fluid and flexible
  • verify with healthcare providers before delivery starts to ensure they are all in agreement
  • nurses discuss lots of these options at admission
  • mobility
  • fetal monitoring
  • surroundings
  • partner participation
  • episiotomy, forceps or vacuum
  • IV
  • C/section
  • bonding
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13
Q

What is the purpose of childbirth preparation classes ?

A

prepare and practice coping mechanisms for labor pain experience

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14
Q

What are the 6 core principles of Lamaze ?

A
  1. labor begins on its own
  2. freedom of movement is crucial
  3. importance of continued labor support
  4. avoid non-medically necessary interventions
  5. non supine position for delivery
  6. no separation of mom and baby after birth for unlimited breastfeeding opportunities
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15
Q

What is the Dick-Read technique ?

A

focuses on the fear, tension and pain cycle
- says that fear causes tension which then increases pain
- comes from “childbirth without fear” book from UK physician

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16
Q

What is the Gaskin maneuver ?

A

it frees the baby’s shoulder when its stuck behind the mom’s pelvic bone

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17
Q

What is the Gaskin technique ?

A

its a low intervention technique to reduce fear during delivery
- have a calm environment and encourage mom with certain words when afraid

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18
Q

What does the Lamaze technique promote ?

A

an unmedicated no intervention birth and a positive bonding experience with baby
- control of pain through breathing techniques
- most well known

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19
Q

What is the Bradley technique ?

A

similar to Lamaze but has a reinforced coach at the bed-side
- used to be known as the husband coach childbirth
- used to be innovative but now questionable because it gives power to the husband/coach over the person giving birth

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20
Q

What is the LeBoyer technique ?

A

infant focused waterbirth
- it focuses more on the newborn experience
- quiet room with dim lighting
- water transition after birth
- good option for low risk moms

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21
Q

What is Hypnobirthing ?

A

a self-hypnosis technique that helps reduce fear of delivery with women
- you train the brain to achieve deep relaxation
- involves positive affirmations, and takes practice
- pt’s are still fully aware and participate in birthing process

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22
Q

Why may someone choose placental consumption ?

A

says it helps prevent postpartum depression and bleeding
- increases mom’s milk supply and helps patient get back iron that was lost during delivery
- usually placenta is packaged into capsules that are consumed

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23
Q

What is a gentle c-section ?

A

this is more about the experience
- there is a clear drape so the pt can see more of what is happening during the procedure
- skin to skin in OR
- play music and delayed cord clamping

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24
Q

Why may delayed 1st bath be chosen ?

A

shown to increase breastfeeding and decrease hypothermia and hypoglycemia
- wait at least 8 hrs or even longer

25
What is delayed cord clamping ?
lets baby get the most blood from the placenta and cord for as long as possible - wait about 30-60 secs before cutting - can be down with term and preterm baby's - increases the iron levels
26
What is a Lotus Birth ?
leaving placenta attached until the umbilical cord falls off naturally - INFECTION RISK and not lots of data to support this - says it can increase blood and nourishment to the baby - less invasive transition from womb to external world - can be a ritual to honor shared life from baby and placenta
27
What is vaginal seeding ?
using cotton swabs or balls that have vaginal fluid on them and placing that on baby's mouth, nose or skin - still being studied - helps replicate the microbiome that baby's go through during vaginal births for C-section baby's - evidence that it decreases chances of asthma, immune disorders and entopic disease
28
What is the definition of infertility ?
couples who haven't been able to get pregnant: - after 1 year of regular unprotected intercourse when the woman is less then 35 yrs of age - or after 6 months when the woman is over the age of 35
29
Why does the definition of infertility change based on the woman's age ?
fertility naturally decreases as you go over the age of 35 yrs old
30
Before the age of 35, what is the chance of getting pregnant each month ?
25-30%
31
What percentage of couples get pregnant within 6 months ?
80% - this is why you wait the 6 months before you take extra steps
32
What is the difference between primary and secondary infertility ?
- Primary: pt has never been pregnant before - Secondary: pt has been pregnant before
33
What are some risk factors for female infertility ?
- Hx of STDs: can cause scar tissue and this can impair fallopian tube uptake - certain meds can cause infertility - genetics - Turner's syndrome: only 1 chromosome - PCOS: ovary fails to release eggs regularly (hormonal) - smoking & drinking - over the age of 35 yrs - irregular periods: hard to track ovulation cycle - any uterine disorder that causes scar tissue - past cancers - obesity
34
What are some risk factors of male infertility ?
- congenital disorders - nutrional deficiencies - obesity - substance abuse & smoking - endocrine disorders (diabetes) - Hypospadias: urethra opening is on the underside instead of tip of penis - Varicoceles: enlarged veins in the testicles that can impair sperm count and motility - STIs - environmental toxins: pesticides, lead, radiation - medications: some anti-hypertensives
35
What are the most common issue that cause male infertility ?
hormone and sperm transport issues
36
What is the first step in fertility testing ?
a thorough history and physical, lab work, and semen analysis - least to most invasive
37
What is the purpose of a pelvic ultrasound in fertility testing ?
looking for abnormal uterine anatomy
38
In the female blood work, what levels may we look at for fertility testing ?
- estrogen - progesterone - follicle stimulating hormone (FSH)
39
In the male blood work, what levels may we look at for fertility testing ?
- testosterone - follicle stimulating hormone (FSH) - gonadotropin
40
In semen analysis testing for fertility, what do they look at ?
sperm count, shape and motility
41
What are the female testing methods for fertility ?
- hormone testing (blood work) - pelvic ultrasound - hysteroscopy - hysterosalpingography
42
What is the purpose of a hysteroscopy in fertility testing ?
inserting a camera into the uterus to look at the health of the uterus - looking for abnormalities
43
What is the purpose of a hysterosalpingography in fertility testing ?
usage of X-ray to look at the uterus and fallopian tubes for blockages or abnormalities - you fill up the uterine space with a dye which then creates a outline of the uterus and fallopian tubes that can be seen through a X-ray to be examined
44
What are the male testing methods for fertility ?
- semen analysis - physical exam - homone test (blood work)
45
What are some medical therapy methods to treat fertility ?
- Clomid - Hormones: progesterone, gonadotropins & FSH supplements - metformin
46
How does Clomid help in fertility ?
helps stimulate ovarian function and ovulation - common 1st line med for couple that has tried for 6 months or 1 yr - increases risk of multi-fetal pregnancy (especially twins or triplets)
47
How does Metformin help in fertility ?
helps induce ovulation by reducing the insulin resistance - good option for pt's with PCOS (polycystic ovarian syndrome)
48
What is IVF ?
invitro fertilization - collect eggs and sperm then you fertilizes the 2 in a lab which creates a embryo which can be transferred into the uterus - "test tube" baby - very expensive - can be from 12,000-20,000 (average is 15,000) and not typically covered by insurance
49
What is IUI ?
intrauterine insemination - you place quality sperm into the uterus at the time of ovulation - good option for men with low sperm count and motility - much cheaper then IVF - about 1,000
50
What is the difference between a surrogate mother and gestation carrier ?
- Gestation Carrier: has no genetic link with the fetus - Surrogate Mother: shares genetic link with the baby and gets paid to do this (have to had at least 1 previous successful pregnancy)
51
What is preimplantation genetic diagnosis ?
taking an embryo and doing testing to identify any genetic disorders
52
Why is embryo storage so controversial ?
what happens to the extra embryo's you don't use - ethical dilemma - do you donate to another person or to research ?
53
What is selective reduction ?
when you implant multiple embryo's to see how many take and then chose from those which to keep - Ex.) you implant 6 and then all 6 take so now you have 6 embryo's but that is a high risk pregnancy so you choose which embryo's to keep - want to avoid complications
54
What are some risk for having multiple fetuses in 1 pregnancy ?
- preterm labor - postpartum hemorrhage - preterm delivery - baby's can end up in NICU (costly)
55
What is Endometriosis ?
where the tissue that normally lines the uterus (endometrium) appears in locations where it shouldn't - typically found around the reproductive organs - causes legions to form which can lead to scar tissue which can lead to infertility
56
Why can scar tissue lead to miscarriage ?
placentas don't like to grow where there is scar tissue so there is an increased risk for miscarriage
57
What are some S&S of Endometriosis ?
inflammatory response: - pelvic pain - dysmenorrhea (painful periods or cramps) - painful intercourse
58
What are some treatment options for Endometriosis ?
- NSAIDS during menstruation (for mild symptoms) - oral contraceptives (low dose): can be take for a long period of time and help prevent tissue forming outside the uterus, make periods shorter, and reduce inflammation - GnRH agonist: can medically induced menopause which can help suppress the endometrial lesion formation - laparoscopy: removal of lesions if you have more severe symptoms (can still get pregnant) - TAH (total abdominal hysterectomy): for pt's that don't want to get pregnant and if symptoms are bad

OB/Community Health (12 decks)

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